APRIL 3, 2003. Two years into a recalcitrant economy, have HIV drug advertisers dropped spending in some publications because of tough times, or are repercussions from old attacks on ad images of hunky guys to blame?

A Changing Market?
POZ magazine has experienced a steady drop in direct-to-consumer HIV drug advertising every year since 1999, its strongest year, according to publisher and CEO Brad Peebles. While he declines to give dollar figures, he says that 2002's total DTC ad revenue was just half that of 1999.

Peebles blames it on the market. "It's just not the same economic opportunity it once was," he says.

"What worked a few years ago doesn't work now," he says. "It's unclear to me what role the economy plays but it is more product lifecycle-driven than macro-economy driven.

"There was such a large explosion of ads because that's where the epidemic was at the time and where treatment was. There were lots of patients ready for that combination. It's Marketing 101  the companies were seeking a return on their investment. Fast forward to today, where there are more and more drugs competing for a smaller and smaller number of patients. Suddenly, there are choices."

Or Intimidation?
When AIDS activist and San Francisco supervisor, Tom Ammiano, charged drug companies two years ago with making HIV look too sexy, the Food & Drug Administration agreed.

The FDA issued a warning to drug marketers criticizing some of their ads for using images ranging from "robust individuals engaged in strenuous physical activity to healthy-looking individuals," concluding that the ads were "misleading because they imply greater efficacy than demonstrated by substantial evidence or minimize the risks associated with HIV drugs."

Indeed, once common images of muscular guys hiking and biking have given way to a series of everyday-looking people contemplating their conditions. One advertising industry executive now speculates that those attacks caused some advertisers to pack up and leave.

Howard Buford, president of New York-based Prime Access, which has handled a number of drug company clients, says, "I've been in meetings regarding HIV medications and they were skittish of going forward with advertising to meet the demands of community groups. There was a fear of severe criticism, regardless of the direction they took the advertising."

Other Publications Stay Flush
AIDS activists have long criticized drug companies for their huge profit margins, which for some regimens can cost about $15,000 annually, about the same price as single full page ad insertion in some magazines. It seems a worthy investment if even a few new patients are landed from an ad. Indeed, while POZ has had its difficulties, HIV drug advertisers are still sinking dollars into The Advocate and OUT.

According to publisher Joe Landry, HIV drug ad spending "started off slowly in 2002, but picked up momentum in [the second half of the year] ending above 2001" total revenues. He adds that there are "no long term signs that things have been adversely affected."

The early part of this year is "producing nicely," Landry says, but the highly secretive drug advertisers have offered no long term commitments, "so I have no idea what's in store for the remainder of 2003." Recent issues of his magazines carry ads for GlaxoSmithKline's Combivir featuring Magic Johnson (along with a similar looking HIV education campaign), Bristol-Myers Squibb Co.'s Sustiva, and Abbott Laboratories' Kaletra.

General media spending for some brands has fallen, but more are modestly up. Bristol-Myers' four-year-old Sustiva, which once carried unique ads depicting a gay male marriage, slipped to $600,000 in ad support from $710,000 in 2001, according to Competitive Media Reporting. Glaxo Wellcome's two-year-old Trizivir (a combination of previous brands Retrovir, Epivir and Ziagen) fell from nearly $1 million in 2001 to $216,000 last year.

Few Non-HIV Drugs Reach Gay Media
Overall, drug advertising hasn't yet developed into a strong business for gay media, so don't expect headache or cold remedies anytime soon. Landry notes "not much progress on pharmaceuticals outside of the HIV virology category." One of the biggest spenders has been Androgel testosterone treatment, which exceeded $5 million in advertising last year, according to CMR. Propecia's budget rose dramatically in 2002 to $1.2 million from under $200,000 in the previous year.

Peebles says he thinks today's HIV ads are "more appropriate, but I miss the aspirational aspect. There seems to be a lot of people standing around 'thinking'  it's a long way from those trippy images of molecules they started out with."

POZ carried a cover story in 2001 about the ad imagery issue, Peebles says. "What was upsetting was a positive image of an HIV-positive person was considered a threat to prevention. We got into the absurd situation of what a 'true' image of a person with HIV should look like. People take sexual risks for all sorts of reasons, and I think it's simplistic to think that it is based on ad imagery."